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Monday, August 12, 2013

Dealing with PTSD, whether you are veteran or spouse or family member requires lots of compassion: compassion for what your veteran has been through, compassion for his/her problems now, and compassion for yourself.
Living with PTSD is not easy for any of us. Bob has been having a worse time than usual this July. It is an anniversary of his worst month in Vietnam. I am practicing my compassion for him and for myself because my old habit of turning into a martyr was trying to sneak back, I had forgotten how to listen, and was starting to give him directions.
Whoops!
So I have to laugh at myself and be compassionate towards myself and him. It is difficult for him and for me, and I don't have to be perfect. And I do need compassion!

Self-Pity is “pity for oneself, especially exaggerated or self-indulgent pity,” according to the American Heritage dictionary. If you feel like a victim, are waiting to be “fixed” by time, a therapist, or God, or if you are waiting for it to magically stop hurting, you may be experiencing self-pity. Being stuck in the past, thinking how unjust it was, or how “if only I had done this or that, it would have come out differently,” is another form of self-pity.Self-pity originates in an innate sense of justice which we all have. Trauma is by its very nature unjust. No one deserves to be traumatized. No one. So the question, “Why me?” is understandable, but it is also unanswerable, or the answer is wrong. If you believe you did something wrong and it caused you to walk into the ambush, or caused your parents to beat you, or that guy to rape you, focusing on that will keep you stuck in “if onlies” forever. Self-pity is contained in the words, “Why me?” It derives from two mistaken myths about life: if you are good and careful and hardworking enough, nothing bad will ever happen to you; and the other one: you should never feel bad. You probably cycle from self-pity to self-criticism: “Why do I feel like this? What’s wrong with me? Why aren’t I over this?” These words bury the pain inside you, so it stays with you forever and eventually it starts to hurt again. That is the problem with self-pity. Over time it keeps you stuck in the past trying to change history. Self-pity becomes a bag of resentments dragged around and dragging you down. It becomes a rejection of reality; reality being that bad things do happen for no reason. Self-pity can also make you quite unkind to others (What are you whining about? I have real problems!).Compassion, (“deep awareness of the suffering of another coupled with the wish to relieve it”) on the other hand, is rooted in reality and based in being real. Bad things happen. No one knows why. They hurt. Compassion is a necessary emotion, one of the major survival adaptations of the species. It gets grownups running into burning buildings to save kids, gets men to run out under a hail of bullets to drag wounded buddies back to cover. It inspires nurses and doctors, medics and EMT’s, rape-crisis counselors, child-protective workers and the ordinary man and woman to do extraordinary things.Compassion activates and motivates helping. As a trauma survivor, you need to help yourself so you will heal. Developing compassion for yourself will give you the power to do so.First, it is important to acknowledge the usefulness of self-pity which kept alive the idea that I didn’t deserve this. The only realistic answer to “Why me?” is that trauma is a part of reality and can strike anyone anywhere. You don’t have to make a mistake to be traumatized. You were not bad, no matter how human you were or how many mistakes you made. You did not deserve to be traumatized. You deserve to recover.If you are mad at yourself for having been hurt and for not getting over it, if you alternate between poor me and lashing yourself for being affected, it is a pretty hard cycle to break. Self-lashing probably has served you in the past, helping you to act when you had no other skills. However, it costs a lot in emotional energy and self-esteem. Compassion is more effective and empowering. Emotional numbing may have repressed it, but compassion is a quality you can develop. People who develop compassion for themselves and others become empowered. They respect themselves and their experiences and do not expect to be unaffected. Compassion for themselves gives them the power to act in their own behalf even when others (parents, the authorities, the military, the Veterans Administration) have not, or have let them down. Self-pity seems to render people hopeless and helpless while they tear themselves up with the idea that it shouldn’t have happened (true) and they shouldn’t hurt (false). How to move from self-pity to compassion? Practice! What are some things you can practice to move from self-pity to compassion for yourself? How can you enhance your capacity to heal?HEALS: Steven Stosny, Ph. D., developed a technique called HEALS which is designed to help you develop compassion for yourself and others (See issues 7 and 12). HEALS causes changes at the core levels of your sense of self. This is where you experience being your true self. Trauma can obliterate your old values and tear apart your self concept. Compassion will increase your self esteem, your ability to nurture yourself, your feelings of being effective, and change how you see yourself in a positive direction. Dr Stosny suggests practicing HEALS 50 times a day. Here’s how:H-When you find yourself trapped in self-pity say to yourself the word “Healing!” Picture it as a flashing neon sign. This moves your consciousness out of the pity-pot, just as it can move it out of the anger file (battering is what it was originally designed to heal). E- Explain what is going on: Say to yourself: “I have been hurt. I’m feeling very natural pain for a trauma survivor. It is okay to hurt.” Identify the feeling. Is it the pain of losing your buddy (grief), or the pain of thinking you should have known it was an ambush (guilt) or both? Is it the pain of name-calling (shame) or the pain of beatings and/or sexual abuse (shame and fear)? It may be several of these. Name them all. It might be one of Stosny’s “core hurts: disregarded, unimportant, accused (guilty, untrustworthy, or distrusted), devalued, rejected, powerless, unlovable, or unfit for human contact.” Try to feel the actual pain for a couple of seconds.A- Apply self compassion. Say to yourself: “I was hurt. I did not deserve to be hurt. Today I can be kind to myself instead of hurting myself more with questions of why or unrealistic self-criticism that I should be over it. I can feel the pain instead of stuffing it with anger or food or drugs or trying to fix people. I can heal. Healing takes time. I can ask for help. I can find support.”Say: “Does the fact that I was abused mean anything about me as a human being? No. I am a good person, worthy of good treatment. All it means is that I was unlucky. My abuser was the one with the problems. S/he hurt me. I didn’t deserve it, no matter what s/he said or did. I deserve to recover and I can recover.”Say: “Does the fact that my war was a no-win situation and we didn’t get the support we expected at home mean there is something wrong with me? Of course not. There was something wrong with the politicians, the war, and the country, but I was a good person trying to do my duty. I was hurt, but I deserve to recover.”Create a personal statement that applies to your situation.L- Love yourself by feeling compassion for your pain. Tell yourself you are lovable, valuable, important and worthy of regard and you can give yourself these things. Even if you don’t believe them, say them anyway. Eventually you will believe.S- Solve the problem that caused the self-pity/self-criticism, i.e. ask for the help you need, take that nap when you are tired, call the vet center or the rape crisis counselor or whatever you need. Do HEALS 50 times a day if you can!Self-Talk: If you don’t want to use something as systematic as HEALS (although I highly recommend it), observing your “self-talk,” and working towards making it healing and helpful, instead of hurtful and impatient is another technique you can practice. Most of us rent out space in our heads to a lethal critic. It’s the voice that says, “You loser! Get your act together!” or “I can’t win for losing,” or some variation of that. Identifying when you are self-talking, what you are telling yourself (which isn’t easy to do at first because it seems so right and true to you, you’ve never even thought about questioning it), and then changing the messages you give yourself takes time. Doing it will help you develop compassion. Most of us do not identify how cruel we are to ourselves. We must stop if we are to develop genuine compassion and to recover. You can evaluate self-talk on the basis of whether it is true, rational, sensible or helpful. Harsh self-criticism or global catastrophizing are usually none of the above.Compassionate self-talk: “I have been hurt. It takes time to heal. I can give myself time and attention. I can love myself. I can respect my experiences. I deserve to recover.”Look around you for people the age you were when you were traumatized. We can often feel more compassion for others than we can for ourselves. Would you expect a young person to be unaffected by what you suffered at that age? Seeing how young you were can help you develop compassion for yourself. Visualize that inner child, inner vet, inner rape survivor or whomever and give him or her the same compassion you would give to another survivor today.If you wouldn’t feel compassion for another survivor, it is evidence that you were traumatized at a young age. This is because to survive, children who are traumatized have to answer the question, “Why me?” with “I’m bad. I deserved it.” By believing that, they can hope to become good and earn better treatment. Without hope, they will die. Since children are by nature childish and self-centered, believing the trauma is their fault is pretty natural for them. Abusers reinforce this by blaming their victims. Sometimes a person who has experienced this develops a very hard shell and despises people who are hurt or who show pain. Compassion is one of the ways to dissolve that hard shell and heal.Growing out of the belief that you caused the trauma is important for trauma survivors, especially since trauma can smash you back a few developmental stages. Under stress, you may find yourself acting or wanting to act as if you were the emotional age you were when traumatized or even younger. Awareness: Any action which increases awareness will also increase the ability to be compassionate which is based on “the deep awareness of the suffering of others.” Even physical actions like mindful walking, running, dancing, martial arts, or singing can bring you to awareness of your feelings. They also empower you in a physical way, which can be very helpful in dealing with emotional pain. Various forms of meditation and prayer, and the “one-day-at-a-time” concept in 12-Step programs, also teach you to be here now, aware and living in this day, this hour, this minute. Once you can be aware of now, you can extend your awareness into your feelings and learn compassion. I find it very useful to do something my friend Katherine mentioned if I am in emotional pain when I meditate. I say to myself, “I am a good person,” and as I say it, I strike my chest. It really brings me into the moment and affirms my right to be in pain as well as my right to recover.Another awareness technique which a therapist I admire teaches to her clients, (one of whom passed it on to me) is stop, drop, and breathe: When you notice a feeling, stop to identify the feeling, drop into the feeling, allow room for it inside you, and then breathe. Remember it is okay to hurt. Genuine painful feelings are not self-pity. When bad feelings arise, remind yourself that it is normal to be affected by trauma.This too shall pass. It is painful. It is okay to be in pain. Reach out to that suffering person inside you as if he or she were a friend. Have compassion for yourself.Small steps: “...the wish to relieve” suffering is the other half of the definition of compassion. What do you wish for to relieve your suffering? How can you break it down into small steps that can actually be accomplished instead of being overwhelmed by big unreachable goals ? For example, suppose you wish to be happy. Break it down into a list of things that make you happy. Maybe you can do some of them today. To discover what makes you happy, you have to be aware enough to observe what actually does make you happy, instead of what’s supposed to make you happy.If you wish to be able to go out socially without being triggered, break that down into manageable parts: spend time to identify your triggers (awareness), find places to go that don’t trigger you (research on what you like to do and what feels safe for you), and/or find therapy that helps you become less easily-triggered (ask other survivors for the names of therapists, call for introductory appointments, interview the therapist to see if he or she is someone you could work with, find out about his or her training, practices and beliefs).If you wish for a healthy loving relationship, figure out the steps that might get you to your goal. Any plan you come up with will probably go through several revisions based on experience. It is okay to make mistakes. Try different approaches.Asking yourself questions: In the American Heritage Dictionary, phrases defining synonyms for compassion include “sympathetic, kindly concern aroused by the misfortune...or suffering of another...a feeling of sorrow that inclines one to help or to show mercy...the expression of pity or sorrow:..the act of or capacity for sharing in the sorrows or troubles of another...a formal, conventional expression of pity...a vicarious identification with and understanding of another’s situation, feelings, and motives.”Are you capable of “kindly concern” for yourself, or are you always flipping between “Poor me,” and Get over it!”? All-or-nothing thinking promotes self-pity.Do you help yourself when you are having a hard time? Learning to identify emotions you’ve repressed or neglected will help you feel and release them. Even if they come back, you will handle them better each time.Do you push yourself? If you do, HALT is a good slogan. Don’t get too hungry, angry, lonely or tired. Do you ask for help? Asking for help is another healing behavior especially if you ask early and often and before you are desperate. If you ask when you are desperate, it can appear to be a demand. Do you have the capacity to share your sorrows with yourself or with a few trusted friends? Do you give yourself formal expressions of sorrow and compassion for what happened to you?Can you identify and understand your situation, feelings and motives? Everything a trauma survivor does is something he or she thinks will make him or her safe. Are your actions realistic? If not, maybe you can figure out how to make them more realistic. Do you feel safe? Is life the way you would like it to be?How has this affected you? No one deserves to be traumatized, but if you were, realism suggests that it has affected you. It is time to change the question from, “Why me?” to “How has this affected me?” Most trauma survivors can give you a list. However, if you are a hard case, just barely beginning to realize you were even affected, this kind of self-awareness—examining yourself for symptoms—will give you a baseline for compassion for yourself. Every symptom started out as a survival skill that helped keep you alive.Look at the adjective, compassionate: “Concerned with human welfare and the alleviation of suffering, charitable, humane, humanitarian, merciful.”Are you merciful to yourself?Are you working to alleviate your suffering? Looking out for your own welfare? Or are you abusing yourself with harsh judgments, unhealthy behaviors or substances?How kind is your treatment of yourself? Do you have realistic expectations of yourself as a trauma survivor? Do you accept your natural, necessary pain or tell yourself to stop whining?John Bradshaw in Healing the Shame That Binds You suggests saying, “I love myself. I will accept myself unconditionally,” out loud and often. This heals shame and develops self-love, which is an element of compassion. If you also feel like you hate yourself or parts of yourself, that is okay. Bradshaw says we often dislike people we love, but it doesn’t mean we don’t still love them. The process of learning compassion includes learning to accept and love yourself as you are. It includes identifying your defenses and survival skills that are not very effective today so you can create the kind of life you want and find healthier happier ways to meet those needs. Bradshaw also recommends giving yourself time and attention, learning to be assertive, as opposed to either people-pleasing or aggressive behavior, and reframing mistakes. Everyone makes them. Self-pity leads you to think you are a mistake. Then you may try to become perfect, which will only make you hard to live with, not perfect! Mistakes serve a lot of useful purposes. They can be warnings. They can result from spontaneity and willingness to learn and play. They can be great teachers, if you are aware enough and flexible enough to learn from them. Bradshaw also recommends a commitment to becoming more aware of what you plan to do and what might come of it, using the experiences of the past and thinking through the likely consequences. This is a compassionate thing to do for yourself.I’ve had a lot of experience with self-pity and self-criticism. I hated myself for not being perfect and treated myself harshly. I couldn’t figure out why I had problems, and I could never make them go away. It took me a long time to develop compassion for myself. It certainly wasn’t a concept I had ever thought about or felt that I needed, but I believe it has helped me heal more than almost any other quality I have developed (except for its twin, acceptance). Compassion is the kind of survival skill which never loses its usefulness. Compassion for yourself is essential for recovery. Once you have that, you will find you can say what it says in the Big Book, Alcoholics Anonymous: “...we will find that the people who wronged us were perhaps spiritually sick,” but the harm they did us will no longer be able to kill us or drive us to kill ourselves, slowly through addictions or swiftly through suicide. We are out of their power. Because we have self-compassion, we simply don’t take any more abuse. We have the energy to work toward healing and the capacity to be kind to ourselves in the process. Compassion means we also will not find ourselves inadvertently or intentionally hurting others. We can see their pain and reach out in fellowship, because we acknowledge and accept our own.

About Me

I'm the wife of a Vietnam vet, Robert Mason, who wrote the book, Chickenhawk, a memoir of his tour as a helicopter pilot, who came home with PTSD. 51st anniversary on Dec 2. We have been through a lot. Recovering from the War is the book I wrote when we found out about PTSD. I continue to write about it. I am also working at writing fantasy and scifi for young adults and picture books.

Welcome to my Blog on PTSD

My blog is intended to help you find help for yourself, whether it is you or your spouse that has PTSD.I have very decided opinions on what PTSD is, a collection of survivor skills that help you at the time of the trauma but can later become your biggest problems.I am glad to see attempts at resilience training in the military, but I tend to doubt that it actually prevents PTSD, especially since resilience has historically been a code word for workaholism, something psychiatrists tend not to notice.There is no one-size-fits-all treatment for PTSD, and although you may find a treatment which helps with all your most distressing symptoms, I prefer the word remission to the term cure, since as yet there are no 20 or 50 year follow up studies on any treatment. That way, if you find your symptoms returning when there is another war or other trauma, you know that what worked once will work again and you can go for more help.Research has shown that traumatic events are cumulative, starting in childhood, and the effects are worse when human cruelty, neglect, betrayal and indifference are part of it. PTSD is even worse when the institutions which are supposed to help you, practice cruelty, neglect, betrayal and indifference, as is happening a lot these days. It is just as bad as when a parent or spouse traumatizes someone.I will be blogging on things I have seen to be helpful.